What causes low sex drive?

Desire is affected by the body, emotions, relationships and context. During perimenopause or menopause, changing hormones may contribute to vaginal dryness, discomfort or sleep disturbance, which can make sexual activity less appealing. Genitourinary Syndrome of Menopause describes ongoing vaginal and urinary changes related to lower oestrogen.

Depression, anxiety, exhaustion, pregnancy, the postnatal period and relationship strain can reduce interest. Postnatal Depression may affect mood, connection and desire. Pain during sex, concerns about body image, previous difficult experiences and some medicines can also play a part. Low desire does not have one fixed meaning and is not a personal failure.

Consider when the change began and whether it followed a medicine, childbirth, relationship change, pain, dryness, sleep problem or mood change. A private medical discussion can explore these factors without assuming that desire must be a certain level. Lubrication, treatment for discomfort, rest and honest communication may help while the cause is assessed.

If symptoms relate to menopause, ask about suitable options for vaginal or wider symptoms. Testosterone Therapy for Women may be considered only after a clinician reviews the situation, explains uncertainty and checks for other causes; it is not appropriate for everyone.

Arrange an assessment when reduced desire persists, causes distress, follows a new medicine, or occurs with pain, bleeding, unusual discharge, marked dryness or urinary symptoms. Seek prompt help for severe pelvic pain, unexpected bleeding or symptoms of depression. Get urgent help if you feel unsafe or have thoughts of harming yourself.

Ask whether pain, dryness, mood, hormones, medicines or another condition could be contributing, and what examination or tests are useful. Discuss treatment for discomfort, emotional support, relationship counselling and the potential benefits and risks of any hormone-based option.